Sage Journals: Discover world-class research

Abstract

Background:

A critical incident is described as any unplanned event which causes, or has the potential to cause, injury to a patient. Critical incident debriefing is a team discussion to gather facts and analyse the experience, evaluate lessons learned and provide staff with support. However, this phase is often neglected.

Methods:

This UK-based explorative qualitative study aims to explore perioperative practitioners’ experiences of critical incident debriefing. Data were collected from six participants through audio-recorded, semi-structured interviews. Data were analysed using a thematic analysis framework.

Results:

Five themes emerged detailing the advantages of critical incident debriefing, including addressing staff’s personal needs and learning lessons from incidents, and the disadvantages such as time constraints and unsupportive/uninformative debriefs leading to poor-quality debriefs.

Conclusions:

Implementation of a short debrief immediately post-incident to address immediate concerns, a later in-depth debrief and additional training for facilitators were recommended to improve debrief quality.

Keywords

Critical incident debriefing Perioperative care Postoperative debrief Advantages and disadvantages of critical incident debriefing

Introduction

Over the last 10–20 years, there has been enhanced interest in critical analysis of safety which has influenced health care development (Parmelli et al 2012, Phillips & Tallentire 2024). Nevertheless, at least 718 adverse events occurred within the National Health Service (NHS) Scotland hospitals from January 2020 to October 2021 (Health Care Improvement Scotland 2022). Notably, 68 of these (9.5%) occurred within the surgical operating theatre. In complex systems such as hospitals, critical incidents can be thought of as inevitable (Müller-Leonhardt et al 2014). Notably, these are rarely random events often caused by system weaknesses which allow us the opportunity to learn and prevent further incidents (Brindley et al 2016).

Critical incidents are summarised as any unplanned event which inflicts, or has the potential to cause, harm to a patient and can be considered strongly emotive (Healy & Tyrrell 2013, NHS England and NHS Improvement 2020). Examples of critical incidents include anaphylaxis, cardiac arrest and major haemorrhage leading to morbidity and/or mortality (Couper et al 2013). These incidents pose risk for not only patients but also those professionals involved in care. Sequelae can include severe emotional, physical, cognitive and social disturbance for health care professionals (Müller-Leonhardt et al 2014). Healy and Tyrrell (2013) state that critical incidents can exacerbate stress among staff enough to impede their ability to deliver standards of care.

Debriefing after critical incidents can be a powerful quality improvement tool and educational adjunct that can change team behaviour and positively influence patient outcomes, crucial for service development (Kessler et al 2014). Critical incident debrief (CID) can also provide staff with the opportunity to gain psychological support (Clark & McLean 2018). Modern critical incident debriefing can be thought of as an extension to Jeffrey Mitchell’s early work to support military personnel exposed to trauma in the 1980s. This prompted the earliest described form of critical incident stress debriefing, as part of a wider Critical Incident Stress Management (CISM) system, shown to provide overall service improvements (Regel 2007). This early work has since been adapted to offer psychological first aid to the theatre team when reflecting on critical events (Faron & Hiner 2015, Phillips & Tallentire 2024). Critical incident debriefing focuses on all available facts and perspectives that will improve processes and identify systematic barriers which can be highlighted. Therefore, providing recommendations to inform service developments (Papaspyros et al 2010).

CIDs have similarities with the World Health Organization (WHO) Surgical Safety Checklist, including its modified versions for emergencies, commonly utilised in theatre practice (Waehle et al 2020). This debriefing serves to review the surgical processes, identify safety concerns and foster a culture of continuous improvement (Waehle et al 2020). In contrast, a CID focuses on specific events that are unexpected or have significant emotional or psychological impact on the team. CIDs analyse these incidents, address any immediate concerns and support the emotional wellbeing of the staff involved (Schwendimann et al 2019). While both debriefing processes aim to improve patient safety and team performance, the WHO’s debriefing is considered more routine, emphasising learning from common practice (Waehle et al 2020). CIDs, however, are reactive against events deviating significantly from the norm or with broader implications for staff welfare and organisational learning.

Although health care providers are trained to clinically respond to patient-related incidents, they may not have the resources available to adequately respond to emotions provoked by these incidents (Faron & Hiner 2015, Wykowski et al 2024). Clark and McLean (2018) identified practitioners have two primary debriefing needs after a critical incident: personal reassurance and reaffirmation of their own competency. Despite this, research into the UK experience of critical incident debriefing is lacking, with much of our knowledge extrapolated from studies in intensive care or emergency medicine. This study aimed to explore perioperative practitioners (Operating Department Practitioners’ (ODPs) and theatre nurses) experience of critical events and thoughts surrounding critical incident debriefs to inform service development.

Methods

Participants

This qualitative study utilised purposive and convenience sampling to recruit perioperative practitioners who had experienced multiple critical incident debriefs and a lack of debriefs following critical incidents. Over two months, from January to February 2020, interviews were conducted in one large teaching hospital within Scotland. Sampling and data collection continued until data saturation was reached.

Data collection

Local lead nurses were contacted to advertise the research through departmental email, social media and word of mouth to perioperative practitioners. These lead nurses acted as information gatekeepers, independent from the researcher. The primary researcher was completing a master’s qualification through Glasgow Caledonian University, a partner site of the hospital. On participants registering interest, the lead nurse would provide an information sheet, consent form and the recruitment email address of the primary researcher to self-register their willingness to participate. The primary researcher then ensured informed consent was achieved prior to participation. Through utilising a gatekeeper independent from the research, we intended to minimise conformity bias to best represent the true views of the health care professionals interviewed.

Data collection was undertaken through in-depth one-to-one, face-to-face interviews utilising a semi-structured approach at a date and time convenient to the participant within a quiet on-site office space. The interviews were audio-recorded and lasted between 22 and 42 minutes (mean = 27.1 minutes).

The interview schedule was developed based on the research questions and existing literature, which were reviewed by senior academic staff familiar with perioperative practice. Table 1 demonstrated the semi-structured interview format.

Table 1

Semi-structured interview format

1. Tell me about your experiences of the critical incident debrief.2. Based on your experiences, what are the advantages and disadvantages of having completed a critical incident debrief?3. Based on your experiences, what are the advantages and disadvantages of not having completed a critical incident debrief?Based on the answers provided, prompts were provided utilising open-ended questions in pursuit of in-depth, rich qualitative data.

Data analysis

Following each interview, the transcripts were transcribed verbatim and analysed utilising Braun and Clarke’s (2017) six-step thematic analysis (TA) framework. This was completed through re-reading transcripts to ensure familiarisation of the data, the generation of initial codes and searching for themes. Thereafter, the themes were reviewed, defined and presented within the final report.

Ethical considerations

Ethical approval was obtained from Glasgow Caledonian University Ethics Committee and the NHS Research Ethics Committee. Gatekeeper access was sought from the departmental Lead Nurse who ensured equal access to participate and reassurance that they supported the research. Written consent was given by all participants, which included publication of the results.

Results

Six participants, three nurses and three ODPs, were interviewed (P1–6). Following TA, five themes emerged.

Theme 1: Time constraints

During the data collection stage, all participants had experienced time constraints inhibiting critical incident debriefing:

P6:

We had no time. There were more cases to do so we had to crack on.

Participants felt workload had a significant impact on critical incident debriefing. Elective and emergency theatres both have demanding workloads; however, emergency surgery has additional time sensitivity due to case acuity:

P4:

The majority of incidents would happen in ‘CEPOD’ (emergency theatre) and literally, we cannot stop before the next procedure as it is the emergency theatre, so we just carry on.

P3:

We should have debriefed but it was a very busy labour ward, and we couldn’t stop.

Critical incidents themselves often cause operating lists to run late, with debriefs adding to delays:

P6:

These things always happen well after shift hours, on a Friday evening.

Participants felt the only time they could debrief, without being interrupted by clinical demands, was at shift end, although they acknowledged that staff may well be disinclined to stay late due to other commitments or being physically exhausted after the incident:

P6:

Debriefing just does not happen at the end of a shift because people are exhausted.

Some displayed emotive descriptions where they felt time constraints should not prevent critical incidents:

P1:

Disadvantages of debriefing? Time constraints. A real issue but still a well-used excuse.

P2:

Time was not my priority. I wanted to debrief, and people just moaned about it being late.

Theme 2: Learning from mistakes

The purpose of critical incident debriefing is to highlight areas of optimal and suboptimal working to improve future practice:

P3:

Debriefing gives the opportunity to ask questions and we can see how we learn from those mistakes as a department.

Many responses related learning from experiences, and debriefing ensured all staff members learned the same lesson. Learning from debriefing was discussed almost ubiquitously positively. All participants recognised critical incident debriefing highlights learning opportunities:

P1:

Debriefings lead to highlighting an issue for example, with equipment that the whole department uses and would solve many problems.

P4:

Debriefing allows reflection and analysis of the incident to inform decisions for future practice.

Participants also discussed misunderstandings staff may feel without having a debrief:

P2:

Without debriefing you could be left unsure. Without having that learning, you can get practice developing in a way you might not want it to be.

Participants highlighted without information being shared, opportunities for departmental service development and learning opportunities were lost:

P3:

They essentially ripped that learning opportunity away from me and the whole team through not talking about it.

Participants felt invested in critical incidents and aspired to be informed about how incidents have impacted future practice:

P4:

I would like to know if any change of practice came from the incident and did that change stop the same thing happening again?

However, one participant highlighted that hot debriefing does not always have the desired effect, expressing frustration over a specific example:

P2:

I needed to reflect, and I think I would have learned more from the debrief if I had reflected first, so really, I learned nothing.

Theme 3: Fear of persecution

While discussing debriefing, most participants described ‘blame culture’ within the NHS and the disadvantage/barrier it has on debriefing:

P5:

I can see why it could bring fear for those who maybe feel to blame and they would not want to debrief in case they got called out and embarrassed in front of everyone.

In addition, there was emphasis on the severity of blame which can occur; one participant discusses a particularly distressing incident on the labour ward highlighting the emotive nature of critical incidents:

P3:

What happened after the incident could only be described as carnage. There became a witch hunt within labour ward against the midwife and the sister who was in charge.

Debriefing allows constructive feedback to be given, but participants discussed experiences of direct and indirect blame through facial expressions, tone and posture. A participant discussed indirect negative feedback given at a team debrief they had experienced:

P1:

It looked quite clearly that they were trying to aim the blame in the direction of one member of the nursing staff.

Participants highlighted the need to address concerns without introducing blame into the debrief:

P2:

If you have not done well, I think there is way of putting that across without being condescending.

A debrief can defuse emotions, allowing thoughts and feelings to be expressed after critical incidents and provides useful stress relief for staff. However, the debrief should not be a critique, but a systematic review of events leading to, during and after the incident. The long-term impact, particularly the psychological sequelae from ineffective debriefs, was discussed by most participants:

P3:

All of the bullying, gossiping, witch hunting led to the long-term sickness of staff.

Theme 4: Unsupportive and uninformative

Although participants acknowledged the learning needs critical incidents highlight, discussion often related to personal needs, such as recognition of clinical competence and addressing their feelings:

P6:

It is good to hear words of encouragement and put your mind to rest.

Participants noted that neglecting to address personal needs of staff could have significant consequences. Some recalled events labelled as ‘horrific’ with lasting personal anguish:

P4:

That happened years ago, and I will die with those boys faces still firmly on my mind.

Failure to engage in debrief impacted the confidence of practitioners. Furthermore, participants highlighted a lack of support from their managers and resulting uncoupling from their departmental teams:

P3:

We (staff) are suffering as a result of not debriefing. I think there should be something in place to ensure management support their staff because it is not happening.

Participants discussed receiving feedback through the means of an email after the incident to summarise events and actions taken to improve care:

P4:

We had some feedback weeks after an incident through an e-mail which had an action plan for preventing the incident occurring again.

The quality of debriefing sessions was highlighted regarding ill-prepared facilitators. Participants discussed debriefs being unstructured, uninformative and unsupportive for staff due to the lack of facilitators training or experience:

P4:

They spoke about the patient as if they are just another number. The quality of that debrief was so poor and there was no concern over staffs’ well-being.

P1:

I have never been offered training on how to conduct a debrief properly . . .

P5:

The quality of the debrief can be a bit variable. I have had debriefs where they have jumped about – it was all over the place. Those types of debriefs leave you more confused.

Theme 5: Need for a critical incident guideline

During data collection, most participants enquired if the NHS had a policy, protocol or guideline and were surprised to hear there was no uniform method to debrief:

P3:

I would love to see some sort of policy. We need something to initiate the conversation.

Furthermore, most participants welcomed the concept of a guideline. However, participants challenged blindly implementing guidelines and suggested further discord if they were implemented poorly:

P2:

All of these policies and protocols are just another tick box exercise. Policies are just a get out of jail cards for management. . .. Not all policies work for every circumstance. It is like that saying, ‘one size fits all’ – it is rubbish.

P3:

We are all mature enough as professionals to understand why a critical incident warrants something without it becoming another tick box scenario.

Discussion

Time constraints

Time constraints are not new to the NHS. Despite numerous strategies to improve efficiency, we have the challenges of record high surgical waiting lists amid nationwide staffing crisis. Participants found it difficult to find time for critical incident debriefs in-hours. This is comparable, with Robertson-Smith (2016) reporting only 24% of incidents debriefing after staffs’ scheduled time. Due to time constraints caused by workload and time critical cases, critical incident debriefing can be difficult to implement. The results in this study within the theatre department reiterated the results in both Clark and McLean’s (2018) and Berchtenbreiter et al’s (2023) studies in that participants agreed staying late was often the only opportunity to perform a critical incident debrief. As mentioned, a key caveat is often staff availability to stay past their contracted hours.

Timing of critical incident debriefing is debated in the literature, with no standardised approach evident across wards, emergency medicine, theatre or critical care. Maloney (2012) discusses support for staff post-critical incident and recommends that staff must be offered the support immediately after incidents to avoid long-term mental health complications. In contrast, Jackson’s (2017) emergency medicine study argues that staff could experience burnout post-critical incidents and an immediate debrief may not be in their best interests. Clark and McLean (2018) further this debate, suggesting there needs to be an educated decision by the team on whether they should or are able to debrief, for example, when staff are visibly exhausted. Research in intensive care medicine would support a hybrid approach to debriefing: immediate short debrief, minimising time commitments while signposting immediate support, followed by a delayed thorough debrief when staff are more able to engage (Berchtenbreiter et al 2023). In addition to optimising personal support, organisationally, this could allow leaders to address immediate concerns, offering words of affirmation, without undue compromise to the clinical list.

Consideration of a hybrid approach mirrors our study, where one participant was reluctant to engage in an immediate debrief due to exhaustion. Respecting practitioners’ physiological and psychological needs could optimise systems learning from these events. Perhaps refining the critical incident debriefing process at our centre could offer better opportunities for lesson learning and dissemination of learning points to allow practitioners to reflect when able.

Learning from mistakes

Overall, participants expressed their mutual beliefs that critical incident debriefing provides an opportunity to learn on a personal and professional level to inform service development. Debriefing allows the critical incident to be transformed into a learning opportunity for the team. Failure to debrief after critical incidents may lead to learning opportunities being missed, but its inclusion alone does not ensure meaningful learning (Wykowski et al 2024).

One purpose of critical incident debriefing is to highlight areas of suboptimal performance and determine methods to improve future practice, as effectively performed in critical care (Brindley et al 2016). Debriefing after critical incidents has been shown to improve learning and patient-focused outcomes (Chan et al 2017). These findings support this research, as practitioners emphasised the learning opportunities that critical incidents and debriefing provides. Similar learning could be achieved in simulation-based training, although critics would argue its fidelity fails to recreate non-technical factors (Phillips & Tallentire 2024, Werry 2016).

Despite educational opportunities highlighted from critical incident debriefing, Serou et al (2017) found in their review that there is often a lack of subsequent training to inform service development. For example, Kessler et al (2014) demonstrated that if sustainable service development is to occur, results of CID need to be shared with the wider department, thoughts echoed by our participants. This study supports previous research in highlighting these learning opportunities and similarly notes limited evidence of safety measures being implemented post-critical incidents. Gardner (2013) offered a solution – a summary added to the end of a debrief should be made widely available to review the lessons learned. Later, as discussed by Kessler et al (2014), a formal review is recommended, allowing time for any required formal investigations to reiterate learning from the incident. Furthermore, Werry (2016) suggests learning opportunities are rarely presented from isolated cases and recommends a review of common mistakes made to enforce service development.

Fear of persecution

The emphasis of a CID should not be on error or blame (Zigmont et al 2011). Instead, staff should be focused on event causality and prevention. Critical incident debriefing engages staff to uncover underlying rationales for decisions, behaviours or actions. Wolfe et al (2014) and Brindley et al (2016) suggest that debriefs should emphasise that errors are rarely due to an individual’s incompetence but systems issues, mirroring our results in the perioperative environment.

Direct feedback can often be perceived as harsh criticism (Hendren 2013). Gardner (2013) emphasises the impact of non-verbal communication during debriefs and perceived impact. Subsequently, individuals may feel conspired against, prompting negative emotional sequelae which may counter the positive benefits of debriefing. Teams should be trained to effectively debrief; a blame culture would otherwise undermine safety by hiding errors from which we could learn from (Heard et al 2016). Furthermore, to encourage participation, we should consider how we support staff emotionally after these events. Notably, Pinto et al (2014) demonstrated a similar support deficit for staff involved in critical incidents.

Overall, participants suggested fear of blame, including bullying and gossiping, may hinder their involvement in critical incident debriefs. In addition to patient safety, there is the wider impact of staff illness through mental health. This potentially suggests a cost incentive for organisations investing in team debrief.

Unsupportive and uninformative

We can view debriefing as a tool to enhance the mental wellbeing of staff (Couper et al 2013). Critical incidents are typically emotional events with reported effects on anxiety, depression and impaired sleep (Müller-Leonhardt et al 2014). Critical incidents often highlight the exploited system errors impairing patient safety (Kessler et al 2014).

Personal validation is an important component of critical incident debriefs in ensuring staff feel supported (Jackson 2017, Pinto et al 2014). Notably, all participants in this study expressed personal motivation and drive for debriefs to aid in their own emotional wellbeing after critical incidents. With such emotional stakes, we would agree with Kessler et al (2014) who suggested facilitators should be able to direct staff to additional mental health support. Hendren (2013) suggested discord in managerial support of critical incidents, and the results from one participant in this study support their findings.

Our study suggests that debriefs were typically poorly led. Kessler et al (2014) found a lack of trained facilitators was a common barrier to debriefing. Research conducted by Sandhu et al (2014) found the quality of a debrief was strongly dependant on the training and skills of the facilitator, as untrained emergency medicine facilitators were associated with poor debrief outcomes. Our study supports this finding with most participants agreeing that the facilitator had a strong impact on the quality of the debrief. Werry (2016) suggests some hospitals provide training for staff on how to effectively hold a critical incident debrief, but for most, staff improvise. This potentiates similar unstructured, uninformative and unsupportive debriefs for staff (Wuthnow et al 2016). Furthermore, Nocera and Merritt (2017) found expertise and efficiency relies on exposure, experience and opportunities for feedback.

Participants believed training facilitators would lead to more structured and supportive debriefs. Imperatively, research conducted by Johnson et al (2023) and Wykowski et al (2024) following implementation of critical incident training significantly improved facilitators confidence in facilitating debriefs. Perhaps a component of such training should include a follow-up review, as staff in our study felt it would reassure them that the incident has informed change.

Training could include recognised CID debriefing models such as After Action Review (AAR), TeamSTEPPS and Debriefing In-Situ Conversion after Emergent Resuscitation Now (DISCERN). Both models are designed to facilitate structured reflection in theatre environments (Mullan et al 2013). The methodology underpinning these debriefings often employs coaching principles, which emphasise open dialogue, non-judgemental feedback and continuous learning (Munoz et al 2020) which would address the needs expressed by our perioperative practitioners.

Coaching in debriefing involves active listening, asking open-ended questions and providing constructive feedback. This approach fosters a culture of continuous improvement, encouraging team members to identify both successes and areas for improvement without assigning blame (Eppich et al 2016). This methodology not only improves clinical outcomes but also supports team cohesion and communication.

Need for a critical incident guideline

Healy and Tyrrell (2013) found the lack of a guideline for debriefing acted as a barrier to conducting a debrief. Although their study is set in the emergency department, our qualitative analysis mirrored their results, suggesting overlap in perioperative practice. A simple adaptable template would allow multiple departments to engage in CID (Werry 2016).

Most participants agreed a guideline would be of benefit but suggested its implementation should be bespoke to the learning environment. Guidelines, if implemented correctly, could diminish the ‘witch hunt’ culture we witnessed in this study.

Culture factors are perhaps a prominent limitation in our critical incident debriefing, for example, the lead for CID was not standardised. Participants described examples of medical staff (surgical and anaesthetic) or senior nursing/ODP staff leading different critical incident debriefs. With a lack of formalised training pathway, in critical incident debriefing, it can be construed that it is unclear whose role it is. This may in part explain the emotive frustrations by staff described in this study directed at ‘management’ as no one profession or entity universally led these situations. Addressing these cultural limitations through professional ownership of critical incident debriefing, alongside critical incident guidelines and training, may alleviate staff animosity while ensuring quality improvement. We intend to study this concept in future research.

Limitations

All participants volunteered their participation and therefore likely overrepresented those favourable to critical incident debriefing, leading to sampling bias (Parahoo 2014). Despite limitations with sample size, participants were recruited for their relevance rather than representativeness (Pearson 2010). This study represents those who work within the perioperative environment within one site, and although the results appear comparable with current research, further study would be required to determine translation to other sites.

Another limitation can be considered by the lack of medical or support staff included in this study, who may have provided a contrasting viewpoint. However, inclusion of further disciplines was felt to compromise the appreciation of professional identity from the research group and thus limit the value of the TA. It is our intention to expand our research to further disciplines including support staff and non-clinical staff who may also benefit from critical incident debriefing, despite their seldom inclusion in the literature.

Conclusions and recommendations

This study identified advantages and disadvantages to debriefing within the perioperative environment. The findings highlight there are multiple barriers inhibiting debriefing such as time constraints and blame culture. Critical incident debriefs have been found to support staffs’ metal wellbeing and increase patient safety. The research highlights multiple avenues for future practice, including the implementation of short debriefs to voice immediate concerns with a later more in-depth debrief. Further recommendations include practitioner training to lead debriefs in a structured manner. Finally, future research should adopt a multicentre approach to establish the wider service benefits associated with critical incident debriefing.

Supplemental Material

sj-docx-1-ppj-10.1177_17504589241293340 – Supplemental material for Perioperative practitioners’ experiences of critical incident debriefing: A qualitative explorative study

Supplemental material, sj-docx-1-ppj-10.1177_17504589241293340 for Perioperative practitioners’ experiences of critical incident debriefing: A qualitative explorative study by Kelly Y Porteous, Callum Robertson and Agnes Lafferty in Journal of Perioperative Practice

Footnotes

The authors thank the hospital that the research was undertaken within and the perioperative practitioners who participated in this study. In addition,the authors thank their two university supervisors for this guidance and support.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research,authorship and/or publication of this article.

Funding

The author(s) received no financial support for the research,authorship and/or publication of this article.

Ethical approval

This study was approved by School of Health and Life Science Ethics Committee,Glasgow Caledonian University.

ORCID iD

Kelly Yvonne Porteous

Supplemental material

Supplemental material for this article is available online.

References

Berchtenbreiter

Innes

Watterson

Nickson

Wong

2023

Intensive care unit nurses’ perceptions of debriefing after critical incidents: A qualitative descriptive study

Australian Critical Care 37 (2) 288–294

Braun

Clarke

2017

Thematic analysis

The Journal of Positive Psychology 12 (3) 297–298

Brindley

Tuma

Vachhrajani

Lefkimmiatis

White

Pronovost

Baker

2016

The ‘ABCs’ of critical care teamwork: Introduction of a practical checklist

Journal of Critical Care 33 (1) 277–278

Chan

Khong

BPC

Tan

LPL

, et al 2017

Experiences of Singapore nurses as second victims: A qualitative study

Nursing & Health Sciences 20 (2) 165–172

Clark

McLean

2018

The professional and personal debriefing needs of ward based nurses after involvement in a cardiac arrest: An explorative qualitative pilot study

Intensive & Critical Care Nursing 47 (1) 78–84

Couper

Salman

Soar

Finn

Perkins

2013

Debriefing to improve outcomes from critical illness: A systematic review and meta-analysis

Intensive Care Medicine 39 (9) 1513–1523

Eppich

Mullan

Brett-Fleegler

Cheng

2016

‘Let’s talk about it’: Translating lessons from health care simulation to clinical event debriefings and coaching conversations

Clinical Pediatric Emergency Medicine 17 (3) 200–211

Faron

Hiner

2015

Enhancing clinical support and collaboration through creation of a standardized critical event debrief process

Journal of Obstetric, Gynecologic & Neonatal Nursing 44 (s1) S36

Gardner

2013

Introduction to debriefing

Seminars in Perinatology 37 (3) 166–174

10.

Healthcare Improvement Scotland 2022 Adverse events notification system: Update report Available at: https://www.healthcareimprovementscotland.org/his/idoc.ashx?docid=830e9130-8a4e-41ff-a060-feb5306095c0&version=-1 [Accessed February 2024]

11.

Healy

Tyrrell

2013

Importance of debriefing following critical incidents

Emergency Nurse: The Journal of the RCN Accident and Emergency Nursing Association 20 (10) 32–37

12.

Heard

Thomas

Sanderson

2016

In the aftermath: Attitudes of anesthesiologists to supportive strategies after an unexpected intraoperative patient death

Anesthesia & Analgesia 122 (5) 1614–1624

13.

Hendren

2013

Supporting staff after adverse events

Patient Safety Monitor Journal 14 (2) 1–5

14.

Jackson

2017

Bereavement in the pediatric emergency department: Caring for those who care for others

Pediatric Nursing 43 (3) 113–119

15.

Johnson

Pointon

Keyworth

Wainwright

Moores

Bates

Hinsby

2023

Evaluation of a training programme for critical incident debrief facilitators

Occupational Medicine 73 (2) 103–108

16.

Kessler

Cheng

Mullan

2014

Debriefing in the emergency department after clinical events: A practical guide

Annals of Emergency Medicine 65 (6) 690–698

17.

Maloney

2012

Critical incident stress debriefing and pediatric nurses: An approach to support the work environment and mitigate negative consequences

Pediatric Nursing 38 (2) 110–113

18.

Mullan

Wuestner

Kerr

Christopher

Patel

2013

Implementation of an in situ qualitative debriefing tool for resuscitations

Resuscitation 84 (7) 946–951

19.

Müller-Leonhardt

Mitchell

Vogt

Schürmann

2014

Critical Incident Stress Management (CISM) in complex systems: Cultural adaptation and safety impacts in healthcare

Accident Analysis & Prevention 68 (1) 172–180

20.

Munoz

Cortez

Alvarez

, et al 2020

After-action reviews and long-term performance: An experimental examination in the context of an emergency simulation

Human Factors: The Journal of the Human Factors and Ergonomics Society 64 (4) 760–778

21.

NHS England and NHS Improvement 2020 Patient safety incident response framework 2020. An introductory framework for implementation by nationally appointed early adopter Available at: https://www.england.nhs.uk/wp-content/uploads/2020/08/200312_Introductory_version_of_Patient_Safety_Incident_Response_Framework_FINAL.pdf [Accessed February 2024]

22.

Nocera

Merritt

2017

Pediatric critical event debriefing in emergency medicine training: An opportunity for educational improvement

AEM Education and Training 1 (3) 208–214

23.

Papaspyros

Javangula

Adluri

RKP

O’Regan

2010

Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety

Interactive Cardiovascular and Thoracic Surgery 10 (1) 43–47

24.

Parahoo

2014 Nursing Research: Principles, Process and Issues 3rd ed

Hampshire, Palgrave Macmillan

25.

Parmelli

Flodgre

Fraser

Williams

Rubin

Eccles

2012

Interventions to increase clinical incident reporting in health care

Cochrane Database of Systematic Reviews 8 (8) CD005609

26.

Pearson

2010

Evidence-based healthcare and qualitative research

Journal of Research in Nursing 15 (6) 489–493

27.

Phillips

Tallentire

2024

Routine versus prompted clinical debriefing: Aligning aims, mechanisms and implementation

BMJ Quality & Safety 33 (5) 280–283

28.

Pinto

Faiz

Bicknell

Vincent

2014

Acute traumatic stress among surgeons after major surgical complications

The American Journal of Surgery 208 (4) 642–647

29.

Regel

2007

Post-trauma support in the workplace: The current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK

Occupational Medicine 57 (6) 411–416

30.

Robertson-Smith

2016

An exploration of the factors that influence the successful implementation of the World Health Organization Surgical Safety Checklist

Journal of Perioperative Practice 26 (11) 243–249

31.

Sandhu

Eppich

Mikrogianakis

, et al 2014

Postresuscitation debriefing in the pediatric emergency department

CJEM 16 (5) 383–392

32.

Schwendimann

Blatter

Luthy

, et al 2019

Adherence to the WHO surgical safety checklist: An observational study in Swiss academic center

Patient Safety in Surgery 13 14

33.

Serou

Sahota

Husband

, et al 2017

Systematic review of psychological, emotional and behavioural impacts of surgical incidents on operating theatre staff

BJS Open 1 (4) 106–113

34.

Waehle

Haugen

Wiig

Softeland

Sevdais

Harthug

2020

How does the WHO Surgical Safety Checklist fit with existing perioperative risk management strategies? An ethnographic study across surgical specialties

BMC Health Services Research 20 111

35.

Werry

2016

Informal debriefing: Underutilization in critical care settings

The Canadian Journal of Critical Care Nursing 27 (4) 22–26

36.

Wolfe

Zebuhr

Topjian

, et al 2014

Interdisciplinary ICU Cardiac Arrest Debriefing Improves Survival Outcomes

Critical Care Medicine 42 (7) 1688–1695

37.

Wuthnow

Elwell

Quillen

Ciancaglione

2016

Implementing an ED Critical Incident Stress Management Team

Journal of Emergency Nursing 42 (6) 474–480

38.

Wykowski

Merel

Starks

, et al 2024

An embedded curriculum to teach critical incident debriefing to internal medicine residents

Journal of Graduate Medical Education 16 (1) 59–63

39.

Zigmont

Kappus

Sudikoff

2011

The 3D model of debriefing: Defusing, discovering, and deepening

Seminars in Perinatology 35 (2) 52–58

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.02 MB

0.00 MB